- 期刊
Successful Treatment of Infected Lymphocele Following Major Gynecologic Surgery by Computed Tomographic-guided Drainage
以電腦斷層定位引流成功治療重大婦科手術後之感染性淋巴囊腫
摘要
目的：淋巴囊腫是大型婦科手術後熟知的後遺症。這類積聚通常是沒有症狀及自限的，但感染性淋巴囊腫則需要進一步治療。我們評估以微侵入性的電腦斷層定位引流方式代替開刀方式治療這種後遺症的成效。 材料和方法：研究的材料收集從1998年7月到2003年7月，總共有13個病例被收集及做進一步分析。資料的收集包括淋巴囊腫的位置，大小及引流的時間。 結果：發燒及疼痛為最常見的臨床症狀。從當初開刀到發現感染性淋巴囊腫的時間從1個月到31個月不等（平均5.8個月）。電腦斷層定位引流對所有13個病人解除疼痛及發燒的症狀。引起發炎的細菌包括革蘭氐陰性及革蘭氐陽性菌種。引流管放置引流的時間從6日到29日不等（平均12.9日）。所有的病人都能容忍治療的程序而且沒有明顯的後遺症。 結論：淋巴囊腫通常是發生在開刀後的幾週內，但我們發現感染性淋巴囊腫通常是在開刀後幾個月而不是幾週內表現出來。以電腦斷層定位引流方式治療這類病患都能使病人在臨床上得到發燒及疼痛的緩解。電腦斷層定位引流是有效，安全及高耐受的治療方式，為感染性淋巴囊腫手術治療的良好替代治療方法。
並列摘要
Objective: Lymphocele is a well-known complication of major gynecological surgery. Most collections are asymptomatic and self-limited, but infected lymphoceles need further management. We evaluated the effectiveness of this minimally invasive procedure as an alternative to surgical treatment. Material(s) and method(s): From July 1998 through July 2003, 13 cases of infected lymphoceles were retrospectively reviewed. Location of the lymphoceles, size, and duration of drainage were recorded. Result(s): Fever and pain were the most common presenting symptoms. The interval between the initial surgical procedure and the presentation of an infected lymphocele ranged from 1 to 31 months (mean 5.8 months). CT-guided drainage resulted in relief of pain and defervesence in all 13 patients. The causative organisms included both gram positive and gram negative bacteria. The duration of catheter drainage ranged from 6 to 29 days (mean 12.9 days). All patients tolerated the procedure well, and there were no significant complications. Conclusion(s): While lymphoceles may form a few weeks after surgery, but we found that infected lymphoceles usually became clinically apparent a few months instead of weeks after operation. CT-guided percutaneous drainage is effective, safe, and well tolerated. It provides a good alternative to open surgery for infected lymphocele.